UHSP Collections (University of Health Sciences and Pharmacy)
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Equal Opportunity, Harassment and Nondiscrimination Policy
No full textUniversity of Health Sciences and Pharmacy in St. Louis’s policy of nondiscrimination is congruent with our core values of discovery, diversity, inclusion, integrity, respect and service. Together, our policy and core values foster an inspiring culture to advance the University’s mission and equal opportunities in employment, our academics, programs and services. All qualified applicants, employees and persons covered by this policy will receive consideration for employment and will not be discriminated against on the basis of race, color, religion, national or ethnic origin, sex (including gender identity or expression, sexual orientation, and pregnancy), age (40 or over in the employment context), citizenship (where prohibited by federal law), genetic information, veteran status or status as an individual with a disability consistent with applicable federal, state, and local laws.
The policy covers reports, complaints, investigation and adjudication relating to matters involving discrimination and harassment, including allegations of sexual harassment against employees that may not otherwise be covered under the University’s Title IX policy. This policy will be administered consistent with the University’s obligations under Title VI and Title VII of the Civil Rights Act, Section 504 of the Rehabilitation Act of 1973, the Violence Against Women Act, and other federal, state and local anti-discrimination laws. Persons are protected from retaliation for making good faith complaints and opposing discrimination and harassment or participating in internal or external proceedings. Sexual harassment as defined by Title IX is covered under the University’s Policy Against Sex-Based Discrimination in Educational Programs or Activities (Title IX) https://collections.uhsp.edu/humanresourcespolicies/15/
Student Fees Policy
No full textThe purpose of this policy is to establish the procedures for setting and approving fees charged to students by the University
Heart rate and blood pressure in male Ts65Dn mice: a model to investigate cardiovascular responses in Down syndrome
No full textDown syndrome (Ds) is the most common chromosomal cause of intellectual disability that results from triplication of chromosome 21 genes. Lower blood pressure (BP) and heart rate (HR) in response to exercise and other stressors are prevalent in Ds, and are mediated by autonomic dysfunction. The Ts65Dn mouse is a model of Ds that is commonly used in preclinical studies, but has not been formally investigated for cardiovascular responses in conscious mice. Based on human studies of Ds, we hypothesized Ts65Dn would have lower BP and HR, but similar arterial stiffness. BP was quantified in conscious wild-type (WT) and Ts65Dn. A main effect for strain was observed for all BP measures (systolic, diastolic, mean, pulse pressure), with WT higher than Ts65Dn. Pulse wave velocity was similar between WT and Ts65Dn. High-frequency power spectra was higher in WT suggesting autonomic differences between strains. Freely moving HR was higher in WT versus Ts65Dn in both the dark and light cycles, although a main effect of circadian cycle was also present (dark\u3e light). Similar to what is observed in humans, Ts65Dn has a lower BP which may be attributed to autonomic differences and result in preservation of arterial function with advancing age. Ts65Dn thus appears to capture the Ds cardiovascular phenotype across the lifespan. These data support further use of Ts65Dn to investigate mechanisms that may lead to altered BP and HR responses in Ds
Circadian rhythm-dependent and circadian rhythm-independent impacts of the molecular clock on type 3 innate lymphoid cells
No full textMany gut functions are attuned to circadian rhythm. Intestinal group 3 innate lymphoid cells (ILC3s) include NKp46+ and NKp46- subsets, which are RORgt dependent and provide mucosal defense through secretion of interleukin-22 (IL-22) and IL-17. Because ILC3s highly express some key circadian clock genes, we investigated whether ILC3s are also attuned to circadian rhythm. We noted circadian oscillations in the expression of clock and cytokine genes, such as REV-ERBα, IL-22, and IL-17, whereas acute disruption of the circadian rhythm affected cytokine secretion by ILC3s. Because of prominent and rhythmic expression of REV-ERBα in ILC3s, we also investigated the impact of constitutive deletion of REV-ERBα, which has been previously shown to inhibit the expression of a RORgt repressor, NFIL3, while also directly antagonizing DNA binding of RORgt. Development of the NKp46+ ILC3 subset was markedly impaired, with reduced cell numbers, RORgt expression, and IL-22 production in REV-ERBα-deficient mice. The NKp46- ILC3 subsets developed normally, potentially due to compensatory expression of other clock genes, but IL-17 secretion paradoxically increased, probably because RORgt was not antagonized by REV-ERBa. We conclude that ILC3s are attuned to circadian rhythm, but clock regulator REV-ERBa also has circadian-independent impacts on ILC3 development and functions due to its roles in the regulation of RORgt
2019 update of the WSES guidelines for management of Clostridioides (Clostridium) difficile infection in surgical patients
No full textIn the last three decades, Clostridium difficile infection (CDI) has increased in incidence and severity in many countries worldwide. The increase in CDI incidence has been particularly apparent among surgical patients. Therefore, prevention of CDI and optimization of management in the surgical patient are paramount. An international multidisciplinary panel of experts from the World Society of Emergency Surgery (WSES) updated its guidelines for management of CDI in surgical patients according to the most recent available literature. The update includes recent changes introduced in the management of this infection
Pharmacy education needs to address diagnostic safety
No full textThe American Association of Colleges of Pharmacy, the Accreditation Council for Pharmacy Education, and the Center for the Advancement of Pharmacy Education frame patient safety from the perspective of medication management, which is also the current focus of pharmacy education and training. With the growing appreciation that diagnostic errors represent an urgent and actionable patient safety concern, the National Academy of Medicine has recommended diagnostic safety training for all health care professions. The Society to Improve Diagnosis in Medicine has worked with an interprofessional consensus group to identify a set of 12 key competencies necessary to achieve diagnostic quality and safety that focuses on individual, team-based, and system-related competencies. Much of this already exists in pharmacy education, but pharmacy training programs need to give graduates more guidance on how they contribute to the diagnostic process and the prevention and detection of diagnostic errors. We describe the current state of progress in this regard, and what steps are needed by training programs to provide content and assessment so that graduates achieve the requisite competencies. Governing and advisory bodies need to expand the expectations around patient safety to include diagnostic safety. Keywords: Interprofessional, diagnosis, educational competency, diagnostic error, patient safety
Association between baseline creatinine clearance and treatment failure in patients with hepatitis C virus treated with ledipasvir and sofosbuvir
No full textBackground. Hepatitis C remains a major cause of liver disease globally and is responsible for approximately 500 000 deaths annually. Newer direct-acting antivirals achieve cure rates at or above 90% with excellent tolerability for most patients. The literature focusing on identification of predictors of efficacy and safety with specific hepatitis C therapies has been inconclusive and often conflicting. Methods. A retrospective, single-center, case-control analysis of all veteran patients aged ≥18 through ≤89 years who completed a treatment course of 8, 12, or 24 weeks with ledipasvir and sofosbuvir (LDV/SOF) combination therapy for hepatitis C infection was conducted. Patients who were identified and met inclusion criteria were assigned to either the case group (SVR12 failure; hepatitis C viral load detectable at least 11 weeks after therapy completion) or the control group (SVR12 success; hepatitis C viral load undetectable at least 11 weeks after therapy completion). Results. Twenty-nine SVR12 failures and 411 SVR12 successes were included in the analysis. The overall failure rate was consistent with the current literature, at 6.6% (29/440). Bivariate analysis identified only baseline creatinine clearance \u3e80 mL min-1 (Cockcroft-Gault) as a possible predictor of SVR12 failure (P = .026). In the multivariate analysis, pretreatment creatinine clearance \u3e80 mL min-1 remained independently associated with SVR12 failure (odds ratio, 2.95; 95% confidence interval, 1.17-7.46; P = .023). Conclusions. In hepatitis C patients treated with LDV/SOF, a pretreatment creatinine clearance of \u3e80 mL min-1 was associated with SVR12 failure
An individualized approach to residency preparation for fourth professional year pharmacy students
No full textIntroduction: The objective of this study was to evaluate the impact of an individualized residency preparation program and faculty mentorship on student preparedness for pursuing residency training and their ability to successfully match with a postgraduate year one (PGY1) residency position. Methods: This prospective cohort enrolled fourth professional year pharmacy students from August 2016 to March 2017. Students participated in a faculty-designed residency preparation program, were assigned faculty mentors, and were provided with several residency preparation resources. The primary outcome was change in the median overall perceived level of preparedness, as measured by pre- and post-residency preparation program surveys. A key secondary end point was the correlation between obtaining a PGY1 residency position and the number of residency preparation sessions attended. Results: Fifty-two students participated in the residency preparation program. The median overall perceived level of preparedness increased following the preparation program. Of the 52 students participating, 37 attended over half of the program sessions. Twenty-one of the 37 (56.8%) students participating in more than half of the sessions matched with a PGY1 program compared to three out of 15 (20%) students participating in fewer than half the sessions. Additionally, students reported value in mock interviews, faculty mentorship, and institution-specific residency preparation guidance delivered via a workbook. Conclusions: Participation in an individualized residency preparation program with faculty mentorship and institution-specific guidance improves the perceived level of preparedness for students pursuing residency training. High attendance at sessions, along with other factors, may contribute to a higher rate of success
Retrospective review of exceptions for angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker recommendations for a diabetic medicare population
No full textBACKGROUND: Renin-angiotensin system (RAS) antagonists are recommended for people with diabetes and hypertension or with elevated urinary albumin excretion. RAS antagonists are beneficial for some, yet clinically inappropriate for others. The percentage of patients for whom RASs are clinically inappropriate has not been compared across health plans. OBJECTIVES: To (a) identify reasons why RAS therapy was not recommended and (b) compare exception percentages between health plans. METHODS: This retrospective, cross-sectional analysis included Medicare Part D beneficiaries with diabetes, enrolled in health plans (n=96) participating in a university-based medication therapy management (MTM) program between January 1 and December 31, 2013. The MTM program evaluated patient eligibility for RAS therapy via (1) a clinically derived software system assessing demographics and medication history, and (2) telepharmacist-delivered medication reviews. The MTM program database calculated the number of patients with diabetes and percentage of RAS therapy exceptions. RESULTS: An average of 55% of patients with diabetes qualified for MTM (range: 19%-88%). Of the 218,589 eligible, 94,359 had 1 or more reasons contraindicating RAS therapy (exception). For an average of 29% of patients, it was inappropriate to recommend the addition of an RAS antagonist; the overall exception rate ranged from 3% to 83%, suggesting a wide variation of exception rates for all health plans. CONCLUSIONS: A substantial difference existed across health plans where RAS therapy was considered clinically inappropriate to recommend for patients with diabetes. Future research must examine variations in therapy exceptions to understand the effect of encouraging broad-population RAS antagonist use
